| Obesity
Contrave vs Qsymia
Side-by-side clinical, coverage, and cost comparison for obesity.Deep comparison between: Contrave vs Qsymia with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsQsymia has a higher rate of injection site reactions vs Contrave based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Qsymia but not Contrave, including UnitedHealthcare
Sign up to reveal the full AI analysis
Category
Contrave
Qsymia
At A Glance
Oral
Twice daily
Opioid antagonist / NDRI combination
Oral
Once daily
Sympathomimetic amine anorectic combination
Indications
- Obesity
- Obesity
Dosing
Obesity Dose escalation over 4 weeks to maintenance of 32 mg naltrexone/360 mg bupropion (two 8 mg/90 mg tablets twice daily) taken orally in morning and evening; not taken with high-fat meal; evaluate response after 12 weeks and discontinue if <5% weight loss.
Obesity Start 3.75 mg/23 mg orally once daily in the morning for 14 days, then increase to 7.5 mg/46 mg once daily; may escalate to 11.25 mg/69 mg then 15 mg/92 mg based on weight loss response; maximum dose 7.5 mg/46 mg in moderate or severe renal impairment or moderate hepatic impairment; avoid in severe hepatic impairment and end-stage renal disease on dialysis.
Contraindications
- Uncontrolled hypertension
- Seizure disorder or history of seizures
- Concomitant use of other bupropion-containing products
- Bulimia or anorexia nervosa
- Chronic opioid or opiate agonist (e.g., methadone) or partial agonist (e.g., buprenorphine) use, or acute opiate withdrawal
- Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs
- Concomitant use of MAOIs, including reversible MAOIs such as linezolid or intravenous methylene blue
- Known allergy to bupropion, naltrexone, or any other component of CONTRAVE
- Pregnancy
- Glaucoma
- Hyperthyroidism
- Concomitant use or within 14 days of stopping a monoamine oxidase inhibitor (MAOI)
- Known hypersensitivity to phentermine, topiramate, or any excipient in QSYMIA, or idiosyncrasy to sympathomimetic amines
Adverse Reactions
Most common (>=2%) Nausea, constipation, headache, vomiting, dizziness, insomnia, dry mouth, diarrhea, anxiety, hot flush, fatigue, tremor, upper abdominal pain, viral gastroenteritis, influenza, tinnitus, urinary tract infection, hypertension, abdominal pain, hyperhidrosis, irritability, blood pressure increased, dysgeusia, rash, muscle strain, palpitations
Serious Suicidal behavior and ideation, neuropsychiatric adverse events, seizures, increase in blood pressure and heart rate, allergic reactions, angle-closure glaucoma
Postmarketing Loss of consciousness, malaise, Brugada pattern/syndrome, drug reaction with eosinophilia and systemic symptoms (DRESS), acute generalized exanthematous pustulosis (AGEP), aseptic meningitis
Most common (>=5%) Paraesthesia, dizziness, dysgeusia, insomnia, constipation, dry mouth
Serious Embryo-fetal toxicity, suicidal behavior and ideation, acute angle-closure glaucoma, mood and sleep disorders, cognitive impairment, metabolic acidosis, decreased renal function, seizure with abrupt withdrawal, kidney stones, oligohydrosis and hyperthermia, hypokalemia, DRESS/multiorgan hypersensitivity, serious skin reactions, anaphylaxis and angioedema
Postmarketing Suicidal ideation, suicidal behavior, acute angle closure glaucoma, increased intraocular pressure, urticaria, elevation of blood pressure, ischemic events, euphoria, psychosis, tremor, anaphylaxis, angioedema, bullous skin reactions (erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis), pancreatitis, hepatic failure, hyperammonemia with or without encephalopathy, maculopathy
Pharmacology
CONTRAVE combines naltrexone, an opioid antagonist, and bupropion, a relatively weak inhibitor of the neuronal reuptake of dopamine and norepinephrine; together they act on the hypothalamus (appetite regulatory center) and the mesolimbic dopamine circuit (reward system) to reduce food intake and body weight, though the exact neurochemical effects are not fully understood.
Phentermine, a sympathomimetic amine, reduces appetite via hypothalamic catecholamine release; topiramate enhances satiety and suppresses appetite through GABA augmentation, voltage-gated ion channel modulation, AMPA/kainate glutamate receptor inhibition, and carbonic anhydrase inhibition, though the precise mechanism of action for weight reduction is not fully established for either component.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Contrave
- Covered on 5 commercial plans
- PA (9/12) · Step Therapy (0/12) · Qty limit (9/12)
Qsymia
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (0/12) · Qty limit (6/12)
UnitedHealthcare
Contrave
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Qsymia
- Covered on 4 commercial plans
- PA (4/8) · Step Therapy (0/8) · Qty limit (0/8)
Humana
Contrave
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Qsymia
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (0/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
No savings programs available for Contrave.
No savings programs available for Qsymia.
Compare Other Drugs
Let us handle your prior authsJust enter your patient's info and we'll:
- Verify eligibility with the payer.
- Pull the right PA forms directly from the payer.
- Submit, track & send live updates to your dashboard.
Free to start · HIPAA compliant
Next Steps for Your Patient
ContraveView full Contrave profile
QsymiaView full Qsymia profile
Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.